<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2306-4102</journal-id>
<journal-title><![CDATA[Acta ortopédica mexicana]]></journal-title>
<abbrev-journal-title><![CDATA[Acta ortop. mex]]></abbrev-journal-title>
<issn>2306-4102</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Ortopedia y Traumatología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2306-41022017000100030</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Continuous pain and swelling after humerus fracture in an 86-years-old woman]]></article-title>
<article-title xml:lang="es"><![CDATA[Dolor e inflamación continua posterior a fractura de húmero en una mujer de 86 años]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Herrera-Pérez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Boluda-Mengod]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Muñoz-Ortus]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gutiérrez-Morales]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pais-Brito]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,University Hospital of Canary Islands Orthopaedic Department ]]></institution>
<addr-line><![CDATA[Tenerife Canary Islands]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de La Laguna Department of Surgery ]]></institution>
<addr-line><![CDATA[Tenerife ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>02</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>02</month>
<year>2017</year>
</pub-date>
<volume>31</volume>
<numero>1</numero>
<fpage>30</fpage>
<lpage>34</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2306-41022017000100030&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2306-41022017000100030&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2306-41022017000100030&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Metastases to bone are the most frequent cause of destructive lesions to the skeleton in adults. The tumours that are most likely to metastasize to bone are prostate (32%), breast (22%), kidney (16%), lung and thyroid. The typical distribution of metastatic lesions are to the spine, ribs, pelvis, and proximal limb girdles. The humerus is the second most common site for long bone metastases, behind only the femur in its frequency of involvement. It represents the 20% of all bony metastases. We present a clinical case of an 86 yo woman with a previous diagnosis of myofibroblastic sarcoma of the maxillaris who suffers a pathological fracture of the humeral shaft secondary to metastasis and was misdiagnosed and treated for a typical humeral fracture using and intramedullary pinning (Hackethal technique), producing the progression of the disease within the humeral shaft. Due to the end state of the disease (multiple metastases), we decided to perform a palliative treatment with radiotherapy. This particular case report does confirm that is very important to rule out a malignancy in cases of osteolytic or poorly marginated lesions, particularly in patients older than 40 years of age. Therefore, it is imperative that the treating physician has a rational and effective approach to the diagnostic evaluation and treatment of these patients in order to avoid a malpractice.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: Las metástasis del hueso son la causa más frecuente de lesiones destructivas del esqueleto en adultos. Los tumores que tienen más probabilidades de metastatizar a los huesos son próstata (32%), mama (22%), riñón (16%), pulmón y tiroides. La distribución típica de las lesiones metastásicas es a la columna vertebral, las costillas, la pelvis y las cinturas escapular y pélvica. El húmero es el segundo sitio más común para metástasis en huesos largos, sólo detrás del fémur en su frecuencia, representando el 20% de todas las metástasis óseas. Se presenta un caso clínico de una mujer de 86 años con diagnóstico previo de sarcoma miofibroblástico de mandíbula que sufre una fractura patológica de la diáfisis humeral secundaria a metástasis, se diagnosticó erróneamente y se trató como si fuera una fractura normal utilizando pinning intramedular (técnica de Hackethal), produciendo la progresión de la enfermedad dentro de la diáfisis humeral. Debido al estadio final de la enfermedad (metástasis múltiples), decidimos realizar un tratamiento paliativo con radioterapia. Este caso en particular confirma que es muy importante descartar una neoplasia maligna en casos de lesiones osteolíticas o mal delimitadas, particularmente en pacientes mayores de 40 años de edad. Por lo tanto, es imprescindible que el médico tratante tenga un enfoque racional y efectivo para la evaluación diagnóstica y el tratamiento de estos pacientes con el fin de evitar una mala práctica.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Pain]]></kwd>
<kwd lng="en"><![CDATA[metastatic]]></kwd>
<kwd lng="en"><![CDATA[bone]]></kwd>
<kwd lng="en"><![CDATA[humerus]]></kwd>
<kwd lng="en"><![CDATA[fracture]]></kwd>
<kwd lng="es"><![CDATA[Dolor]]></kwd>
<kwd lng="es"><![CDATA[metastásico]]></kwd>
<kwd lng="es"><![CDATA[hueso]]></kwd>
<kwd lng="es"><![CDATA[húmero]]></kwd>
<kwd lng="es"><![CDATA[fractura]]></kwd>
</kwd-group>
</article-meta>
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